| Title: |
Clinical Presentation and Causes of Prosthesis-Related Hypersensitivity Reactions: An Analysis of 225 Patients |
| Authors: |
El Saadany, Tamara; Illi, Barbara; Furrer, Pascal Raffael; Fucentese, Sandro F.; Schenk, Pascal; Li, Nick; Lang, Claudia; Bärenfaller, Katja; Zhakparov, Damir; Brüggen, Marie-Charlotte |
| Source: |
International Archives of Allergy and Immunology ; volume 187, issue 3, page 299-307 ; ISSN 1018-2438 1423-0097 |
| Publisher Information: |
S. Karger AG |
| Publication Year: |
2025 |
| Description: |
Introduction: Between 10% and 20% of all prosthesis patients experience implant-related complications within 1–2 years following surgery. Hypersensitivity to components within the prosthesis is a possible cause of these complications. Methods: This study aimed to investigate the characteristics of prosthesis-related hypersensitivity (PRH) and identify possible associated risk factors. A retrospective, monocentric study was conducted at the University Hospital Zurich. Results: A total of 225 patients who underwent patch testing for suspected PRH between 2011 and 2021 were included. The mean age was 72 years; 34% were male and 65% were female. Knee pain was the most commonly reported symptom (85%), followed by eczematous skin lesions and joint instability (each around 20%), as well as redness or swelling (13–16%). In 67% of the patients undergoing patch testing, an allergy was diagnosed. Nickel was the most frequently identified allergen (31.5%), followed by vanadium chloride (13.7%) and gentamycin, an antibiotic, often added to bone cement. 60% of the PRH patients had a previously known contact allergy – 25.7% to metals and 34.6% to other substances. Among the metals, nickel was the most prevalent (19.5%), followed by silver (3.1%). This prevalence was significantly higher than in patients without a metal allergy diagnosis. No significant differences were observed between the groups regarding overall or individual atopic comorbidities (present in approximately 40% of patients). Conclusion: A history of contact allergy may be an indicator of PRH. In contrast, clinical presentation and the consideration of atopic or non-atopic comorbidities in prosthesis patients with suspected PRH do not appear to provide helpful diagnostic clues. Based on our findings, PRH may represent an underestimated cause of postoperative complaints. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1159/000547103 |
| Availability: |
https://doi.org/10.1159/000547103; https://karger.com/article-pdf/doi/10.1159/000547103 |
| Rights: |
https://creativecommons.org/licenses/by-nc/4.0/ ; https://creativecommons.org/licenses/by-nc/4.0/ |
| Accession Number: |
edsbas.C15E4D2A |
| Database: |
BASE |